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2013-02-06 08:01:53
fib Med surg 36

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  1. Risk factors for A-fib
    • age
    • obesity
    • Caucasian
    • excessive alcohol
  2. Are there P waves? Is the QRS pattern normal?
    • no P waves
    • irregular QRS
  3. Why is there no P wave
    the atria are not contracting, p wave is the depolarization of the atria
  4. Why is A-fib a potential for CVA and PE
    since atria aren't contracting blood pools and can lead to coagulation
  5. Why does CO decrease
    • increased rate
    • decreased filling time
    • decreased stroke volume(no atria "kick"/contraction)
  6. Decreased CO can lead to what complications
    • HF
    • hypotension
    • perfusion problems
  7. What are the S/S of A-fib
    • fatigue/weak
    • SOB
    • dizzy/syncope
    • hypotension
    • anxiety
    • palpitaion
    • chest pain
    • asymptomatic
  8. How do we treat A-fib
    • anticoagulants
    • anti-platelets
    • Anti-dysrhythmics
    • cardioversion
    • ablation/maze
    • bi-ventricular pacing
  9. What types of anticoagulants are used to treat A-fib and why
    • Heparin
    • Enoxaparin(Lovenox)-LWMH
    • warfarin(coumadin)-decrease vitamin K intake
    • pooling bllod in atria/ prevent PE/CVA
  10. Which anticoagulant is a bridge until the other starts working
    Lovenox bridge until coumadin is effective
  11. What types of antiplatelets are used
    • ASA
    • clopidogrel(Plavix)
  12. What anti-dysrhythmics are used
    • Ones that slow HR
    • CA++ channel blockers- diltiazem(Cardizem)
    • Amidarone(Cordarone)
    • Beta-blockers- metoprolol(Lopressor)
    • Digoxin(Lanoxin)
  13. What is cardioversion
    an attempt to "reset" heart rhythm
  14. When can cardioversion be done w/out using anticoagulants
    If the pt knows the went into A-fib in the last 48 hrs because the blood hasn't had time to coagulate yet
  15. What is ablation/maze
    block extra electrical impulses so only SA impulses travel to AV
  16. What is bi-ventricular pacing
    implanted atrial defibrillator that sends shock to the heart when arrhythmia occur